Effect of two different nutritional supplements on postprandial glucose response and energy- and protein intake in hospitalised patients with COPD: A randomised cross-over study.

• Published in: Clinical Nutrition
• Main Authors: Ingadottir, Arora Ros, Bjorgvinsdottir, Eva Bjorg, Beck, Anne Marie, Baldwin, Christine, Weekes, C Elizabeth, Geirsdottir, Olof Gudny, Ramel, Alfons, Birgisdottir, Bryndis Eva, Gislason, Thorarinn, Gunnarsdottir, Ingibjorg
• Other Authors: 1Unit for Nutrition Research, Landspitali University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland. Electronic address: [e-mail]. 2Unit for Nutrition Research, Landspitali University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland. 3Faculty of Health and Copenhagen University College, Copenhagen N, Denmark; Research Unit for Nutrition, Herlev and Gentofte Hospital, DK-2820, Gentofte, Denmark. 4Department of Nutritional Sciences, King's College London, London, UK. 5Department of Nutrition & Dietetics, Guy's & St Thomas' NHS Foundation Trust, London, UK. 6Unit for Nutrition Research, Landspitali University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; The Icelandic Gerontological Research Institute, Landspitali University Hospital & University of Iceland, Reykjavik, Iceland. 7Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland. 8Unit for Nutrition Research, Landspitali University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2020
• Subjects: COPD; Energy intake; Hospitalized; In-between meal snacks; Oral nutrition supplements; Protein intake; Dietary Supplements; Pulmonary Disease; Chronic Obstructive; Iceland
• Online Access: http://hdl.handle.net/2336/621416; https://doi.org/10.1016/j.clnu.2019.04.010

To access publisher's full text version of this article click on the hyperlink below Introduction: Oral nutrition support is frequently used in treatment of malnutrition in patients with chronic obstructive pulmonary disease (COPD). Considering the use of corticoidsteroids in patients with COPD, little is known about the effect on postprandial glucose response and if they might interfere with glucose control. Our aims were to compare the effect of a liquid oral nutritional supplement (ONS) and semi solid inbetween meal snack (snack) on postprandial glucose and energy- and protein intake, and to compare the effect of timing of each intervention on postprandial glucose and energy- and protein intake. Methods: Patients with COPD (n = 17) admitted to the Department of Pulmonary Medicine, Iceland and defined as at low or medium nutritional risk (score 0-3) were recruited. In a randomised cross-over design, subjects consumed ONS or snack either in a fasting state (study 1) or following breakfast (study 2) and postprandial glucose responses were assessed at regular intervals for two hours (t = 15, t = 30, t = 45, t = 60, t = 90, t = 120 min). Energy- and protein intake was estimated using a validated plate diagram sheet. Wilcoxon Signed-Rank test was used to compare the two interventions. Results: In study 2, following breakfast, postprandial glucose was significantly higher after consuming ONS than the snack after 60 min (9.7 ± 2.4 mmol/L vs. 8.2 ± 3.2 mmol/L, p = 0.013 and 120 min 9.2 ± 3.2 mmol/L vs. 7.9 ± 2.4 mmol/L, p = 0.021, respectively). No difference was found in postprandial glucose concentrations between ONS and the snack when consumed after overnight fasting (study 1). No difference in energy or protein intake from hospital food was seen between supplement types neither in study 1 or 2. Conclusion: Lower postprandial glucose concentrations were associated with the snack compared to ONS when taken after a meal compared to either type directly after overnight fasting. The clinical relevance of higher ...